Patient Financial Coordinator - Transplant

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

 

Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.

 

Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Patient Financial Coordinator who will embrace our mission of Advancing Health Together.

 

The Transplant Financial Coordinator (TFC ) is part of a multidisciplinary team charged with the responsibility of providing accurate and professional financial clearance to patients seeking Transplant Services at Duke. The TFC is responsible for verifying accurate demographic and financial information and knowledgeable in the review and interpretation of insurance benefits, performs financial counseling, and financial screening.  Establish financial arrangements, refers appropriate cases to other agencies, internal and external, to assist patients with discharge/post hospital care.  Interacts closely with Utilization Review and Transplant Billing to ensure correct and timely reimbursement.

 

In this role you will coordinate administrative services and operations for transplant financial services. Coordination and communication with the patient and clinical team including physicians, nurses, social workers and pharmacists is key for the successful financial analysis and clearance.  Attend weekly and monthly required meetings, maintain transplant work queue’s, and all other tasks and administrative duties as assigned.

 

The Transplant Financial Coordinator has a hybrid schedule Monday through Friday 8:00 am to 4:30 pm as well as being part of the Transplant On-call team when scheduled, which includes working after hours remotely Monday through Friday 4:30pm – 8:00am, holidays and rotating weekends

 

Work is performed under the direct supervision of the Transplant Financial Services Supervisor and/or Financial Services Manager with administrative direction provided by the Financial Services Director

 

 

Primary Duties and Responsibilities

 

Process referrals for transplant evaluation/Insurance Verification/Clininal Coordination:

 

• Detailed patient insurance benef it information for aspects of the transplant process including but not limited to outpatient prescriptions, travel and lodging, studies, and fundraising 
• Review benefits and other transplant financial issues with patients/family members during transplant evaluation.
• Obtain payer authorizations for transplant evaluation and surgical/waitlist
• Coordinate communication between insurance companies, governmental agencies, providers and internal departments
• Work with DUHS Finance, Managed Care Contracting, Pharmacy assistance programs in the development of agreements for International, self-funded patients and patients with limited benefits
• Interact with Transplant and Oncology Clinical teams (Surgeon, Medical Oncologists, RN Coordinators and Transplant Administration) to obtain treatment plans, discharge planning, concurrent and retrospective review and patient demographics to begin insurance verifiation process
• Interview admitted patients to obtain required information to begin verification
• Interact with clinical teams (Surgeon, RN Coor dinators and Administration) prior to a patient’s financial clearance, providing key information and data regarding benefits, support and patient financial liability
• Prepare financial packets based on each individual patient’s benefits, patient financial interview, and calculated estimated expenses based on patient benefits
• Share financial screen daily/weekly with the clinical teams at each of their respective meetings
• Notify the patient if not financially approved for evaluation at Duke and redirect these patients to the insurance payer case manager.

 

Data Maintenance and Billing Information (Transplant specific):

 

• Facilitate resolution of transplant patient billing issues
• Utilize clinical and billing knowledge to recognize and resolve billing errors/inconsistencies
• Understand federal and state guidelines related to organ transplant
• Identify patient in Maestro and accurately identify which guarantor account is to be us